Cardiovascular Response to Sexual Activities

Sexual Activity as a Cardiac Risk Factor

Overall, the risk of myocardial infarction during sexual activity is negligible. Although maintaining sexual activity has been reported to have potential health benefits, it can trigger myocardial infarction (MI), arrhythmia, or sudden death in a very small minority of patients. The Myocardial Infarction Onset Study (MIOS) enrolled 1,712 patients with a first episode of MI. Sexual activity was the potential trigger for MI in 1.5% of cases. Among 858 sexually active in the year before MI, 70 (9%) reported sexual activity in the 24 h preceding the acute coronary event, and 27 (3%) in the 2 h preceding the onset of symptoms. Canadian viagra pharmacy

The relative risk of MI was assessed by “case-crossover” methodology. Overall, the relative risk of MI was increased by two to three times and confined to the 2-h period after sexual activity. After correcting for chance occurrence, 0.9% of cases could be attributed to sexual activity within the 2-h period before MI onset. Of paramount importance was the observation that the risk decreased to none if the subject engaged in regular physical activity (at least three times per week) at moderate workload (5–6 METs). A similar study from Sweden reported identical findings.

A more important concept is the absolute risk of MI during sex. In the Framingham Heart Study, the baseline risk of MI for a 50-year-old non-smoking, non-diabetic man is 1% per year or one chance in a million per hour. As sexual activity increases the relative risk by two to three times, this subject will have a 1.01% risk per year or two to three chances in a million per hour, but only for a 2-h period. In patients who have had a previous MI, the baseline risk of reinfarction for death is: 10% per year, or 10 chances in a million per hour increasing to 1.1% per year, or 20 chances in a million for a 2-h period after sexual activity.

Once again, the risk decreases to <3% if the patient could exercise >7 METs. Coital sudden death is very rare. In three large studies, death related to sexual activity was 0.6% in Japan, 0.18% in Frankfurt, and 1.7% in Berlin. Extramarital sex was responsible for 75%, 75%, and 77% respectively, and the victims were men in 82%, 94%, and 93% of cases, respectively. The partnership of an older man with a younger woman was the most common setting. Excessive drinking and sex too close to a large meal were frequently associated.

Key Points Sublingual Viagra

• Sex between couples in a long-standing relationship is not stressful to the heart.
• Casual sex may lead to exaggerated cardiac responses.
• Simple advice related to normal daily activities is reassuring to the patient and partner.
• An exercise ECG is a valuable method of clarifying uncertainty.